Ateşli nötropenik olgularda aerobik bakteriyel infeksiyonların değerlendirilmesi
Küçük Resim Yok
Tarih
2001
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada ateşli nötropenik olgularda gelişen bakteriyel infeksiyonlann çeşitli yönlerden değerlendirilmesi amaçlanmıştır. Çalışmaya 2-82 yaşları arasında (ortalama:28.47±23.61) 42 erkek, 25 kız toplam 67 hastada 82 ateşli nötropenik atak alındı. Olguların 41 'i lösemi, 9'u lenfoma, 8'i diğer hematolojik malignitelere sahipti ve 9'unda herhangi bir hematolojik malignite bulunmamaktaydı. Olgularda yapılan incelemeler sonucunda, 35 (%42,7) hastada mikrobiyolojik olarak dökümante edilen infeksiyon, 30 (%36.6) hastada klinik olarak tespit edilmiş infeksiyon, 17 (%20.7) hastada nedeni saptanamayan ateş tespit edildi. TNS ile ateş nedenleri arasında anlamlı bir fark görülmemiştir (p>0.05). İkiyüzkırkdokuz numune incelenmiş, 45 patojen izole edilmiştir. Bunlardan 21 'i idrar, 16'sı kan, 3'ü yara, 2'si boğaz, 2'si apse ve l'i damaktan izole edilmiştir. Bunlardan %33.3'ü gram-pozitif, %66.7'si gram-negatif organizmalardır. E. coli en sık izole edilen patojen olmuştur. Olguların %19.5'inde bakteriyemi tespit edildi. Kandan izole edilen 16 etkenden 9 (%56.3)'u gram-pozitif, 7 (%43.7)'si gram-negatiftir. Kandan en sık S. aureus /'zole edilmiştir. Kan kültüründe üreme ile ateş düşme süresi, kemoterapi alması, antibiyotik kullanmış olması, altta yatan hastalığı, akciğer lezyonlarının olup olmaması arasında istatistiksel olarak anlamlı bir ilişki saptanmamıştır (p>0.05). Oral lezyonlar ile kan kültürü pozitifliği arasındaki istatistiksel olarak anlamlı bir ilişki tespit edilmiştir (p<0.05). Olguların %75.6'sında kombine tedavi, %14.6'sında monoterapi, %9.8'inde değişik tedaviler verilmiştir. Olguların 61 (%74.4)'inde tedavide basan elde edilmiş, 8 (%9.8) hasta kaybedilmiştir. İnfeksiyonun mikrobiyolojik olarak gösterilip gösterilmemesi ile tedavi başarısı arasında anlamlı bir ilişki saptanmamıştır (p>0.05). İnfeksiyon etkenleri yönünden merkezler arasında farklılıklar izlendiğinden, her merkez kendi infeksiyon etkenlerim ve tedavi rejimlerini belirlemelidir.
Hie aim of this study was to evaluate the various manifestations of bacterial infections which were ocurred in febrile neutropenic patients. Eighty-two febrile neutropenic attacks in 67 patients (42 male, 25 female) between age 2-82 years (mean 28.47±23.61) were evaluated in this study. Forty-one of the patients were diagnosed as leukemia, 9 as lymphoma, 8 as other hematological malignancies. No hematological malignancies were found at 9 patients. At the end of the examinations, microbiologically documented infection was reported in 35 patients (42.7%), clinically defined infection was reported in 30 (20,7%), and fever of unknown origin was detected in 17 patients. There was no statistically significant difference between absolute neutrophil count and aetiology of fever (p>0.05). Two hundred and forty-nine samples were evaluated and 45 pathogen agents were isolated. Twenty one of the pathogens were isolated from urine, 16 from blood, 3 from wound, 2 from throat, 2 from abcess and 1 from palate sputum. 33.3% of these pathogens were gram-positive and 66.7% of mem were gram-negative microorganisms. E. coli is the most commonly isolated pathogen. Bacteremia were found in 19.5% of patients. Nine out of 16 pathogens isolated from blood were gram-positive, rest of them (n=7) are gram-negative organisms. S. aureus was the most common organism isolated from blood. There was no any statistically significant relation between positive blood culture and duration of fever, receiving chemotherapy, prior antibiotic usage, primary disease and lung lesions. Statistically significant relation was detected between oral lesions and positive blood cultures (p<0.05). 75.6% of patients were treated with combined therapy, 14.6% of patients with monotherapy and 9.8% of them were treated with different therapies. Success in treatment was achieved at 61 patients (74.4%), 8 (%9.8) patients were died. No significant relation between the success of treatment and microbiologically documentation, was demonstrated (p>0.05). There are differences in infectious agents from one to another so each center must define its own agents and therapy regimens.
Hie aim of this study was to evaluate the various manifestations of bacterial infections which were ocurred in febrile neutropenic patients. Eighty-two febrile neutropenic attacks in 67 patients (42 male, 25 female) between age 2-82 years (mean 28.47±23.61) were evaluated in this study. Forty-one of the patients were diagnosed as leukemia, 9 as lymphoma, 8 as other hematological malignancies. No hematological malignancies were found at 9 patients. At the end of the examinations, microbiologically documented infection was reported in 35 patients (42.7%), clinically defined infection was reported in 30 (20,7%), and fever of unknown origin was detected in 17 patients. There was no statistically significant difference between absolute neutrophil count and aetiology of fever (p>0.05). Two hundred and forty-nine samples were evaluated and 45 pathogen agents were isolated. Twenty one of the pathogens were isolated from urine, 16 from blood, 3 from wound, 2 from throat, 2 from abcess and 1 from palate sputum. 33.3% of these pathogens were gram-positive and 66.7% of mem were gram-negative microorganisms. E. coli is the most commonly isolated pathogen. Bacteremia were found in 19.5% of patients. Nine out of 16 pathogens isolated from blood were gram-positive, rest of them (n=7) are gram-negative organisms. S. aureus was the most common organism isolated from blood. There was no any statistically significant relation between positive blood culture and duration of fever, receiving chemotherapy, prior antibiotic usage, primary disease and lung lesions. Statistically significant relation was detected between oral lesions and positive blood cultures (p<0.05). 75.6% of patients were treated with combined therapy, 14.6% of patients with monotherapy and 9.8% of them were treated with different therapies. Success in treatment was achieved at 61 patients (74.4%), 8 (%9.8) patients were died. No significant relation between the success of treatment and microbiologically documentation, was demonstrated (p>0.05). There are differences in infectious agents from one to another so each center must define its own agents and therapy regimens.
Açıklama
Anahtar Kelimeler
nötropenik, neutropenic, aerobik, aerobic, infeksiyon, infection
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Dikici, N. (2001). Ateşli nötropenik olgularda aerobik bakteriyel infeksiyonların değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Enfeksiyon Hastalıkları Anabilim Dalı, Konya.
